73 W 10TH ST MECH 2017 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 41PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACRS17-0089
Description: HVAC- 1 AIC, 1 AHU, 2 TON
Estimated value: 0
Issue Date: 7/5/2017
Expiration Date: 1/1/2018
PROPERTY ADDRESS:
Address: 73 W 10TH ST
RE Number: 170811 0003
PROPERTY OWNER:
Name: BELICH KELLY JEAN
Address: 73 W 10TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work,a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 b 08 q
Ph(904)2477-5826 Fax(904)247-5845 C P's 7-
-t3Zi �`� I,✓ 041, S/ PERMIT
JOB ADDRESS: _/99 5C? fL REQUIRED
y99 ARI#
PROJECT VALUE$ Condenser Only
_Air Handling Equipment Only X Air Handling Unit & Condenser _
NEW AIR CONDITIONING & H ATINGons Pe UM INyS^'I'ALLATION
Qua = Seer Ratine�—
Air Conditioning: Unit Quantity BTU's Pet Unit REQUIRED
Heat: Total CFM
Duct Systems:
REPLACEMENT AIR CONDITIONING &ns P r er Unit S INSTALLATION Rating—/ /
Air Conditioning: Unit Quantity BTU's Per Unit—1ka 0 REQ`UfIRED
Heat: Unit Quantity
Duct Systems: Total CFM
i"
(Requires 3 sets of plans)
FIRE PREVENTION
Quantity (Requires 3 sets of plans)
Fire Sprinkler System
Fire Standpipe Quantity (Requires 3 sets of plans)
Value (Requires 3 sets of plans)
Underground Fire Main
Quantity (Requires 3 sets of plans)
Fire Hose Cabinets
Commercial Hoods Quantity (Requires 3 sets of pleas)
Fire Suppression Systems Quantity
MISCELLANEOUS:
FIRE PLACES Automobile Lifts BTU's
• Prefabricated Fireplace Qty -
Boilers
Gas Piping Outlets Elevators/Escalators —�
Heat Exchanger
ALL OTHER GAS PIPING Pumps BTU'
Quantity of outlets Refrigerator Condenser
#Vented Wall Furnaces — Solar Collection Systems
#Water Heaters Tanks(gallons)
Wells
ON
OTHER: ! �
sea
hcation and know the same to be we and correct. All revisions of laws and ordinances governing this work will be complied with whether $7/
Person becomes void if work does not Warren"within a six-pooch period or work is suspended or abandoned for six months.I hereby certify that have
his app'
g performance oFconswctwn.
�, Phone Number �"
trot The permit does not give,,e to..be
violate the Cc .Son,of any other slate or local law reulation consWclion or e
i Property Owners Name L o.-� Faxes
S r N V G office Phone
Mechanical Company `` !, State�L Zip 3 Z2 7
City tic lift
Co. Address: 71 G/ /0 et istration# CAG7B/ 6/
' License Holder(Print):
41,.
(„/«G✓�s� tate Certificatiori/Reg
• r
Notarized Si nature Ideo`l 1p day of 201
11-
,e%%jFERJ tlGOON
tfl✓:.^.s�+:5 My rpMMiG510N G p619Be Before me
owePublic
ExPtG' e,zr.mm ignSature of Notary
aorAeCtlw No'an